I am writing to express opposition to the Dialysis PATIENTS Demonstration Act of 2017 (H.R. 4143/S. 2065). I strongly believe that this legislation is not in the best interest of all kidney patients.

First, all patients should have a choice in their dialysis provider. Patients should not be involuntarily enrolled into an organization and then be required to opt-out within a specific period of time in order to preserve their freedom of choice. This is an unnecessary burden.

Second, to participate in this demonstration, providers must be able to bear capitation risk or partner with an entity that can. Very few, if any, small and medium dialysis providers could do this. I do not want to see our smaller/nonprofit providers go away or not be able to use them.

Finally, I believe an integrated kidney model should include chronic kidney disease care, palliative, transplantation, medical management and hospice. The Dialysis PATIENTS Demonstration Act covers none of those critical services and requires a patient to leave the organization if that care is needed. Any model addressing integrated care for patients on dialysis should keep all patients in the model so that the patients will not risk being abandoned by their care team at critical times.

Based on these concerns, I oppose the Dialysis PATIENTS Demonstration Act.

I have sent letters to Rep. Gianforte, Sen. Daines and Sen. Tester similar to what is written above. Senators Daines and Tester responded immediately, thanking me for my letter and promising to keep my concerns in mind should the bill come out of committee.

I work with these patients every day. Dialysis patients have families, friends, hopes and dreams just like everyone else. They also have a life-threatening disease that requires constant attention. These patients come to reply upon and trust their doctors and dialysis provider. The choice of doctor and dialysis provider should remain theirs.

I urge you to write to our Congressmen to express your concerns for and disapproval of the Dialysis PATIENTS Demonstration Act.

-- Paul Cannon, MSW, social worker, Billings Clinic Dialysis Center